The role of Candida dubliniensis in oral candidiasis in human immunodeficiency virus-infected individuals

There is an increasing interest in non-albicans Candida species because of the increasing number of fungal infections they cause. Most of these infect ions can be found in immunocompromised individuals, especially in those inf ected with human immunodeficiency virus (HIV). Candida dubliniensis is a re cently identified yeast, mostly isolated in HIV-positive individuals with o ral candidiasis. Candida dubliniensis is a germ tube- and chlamydospore-for m yeast. Thus, it shares diagnostic characteristics with Candida albicans. Probably, Candida dubliniensis has been present in the community for a long time and has been misidentified as Candida albicans. Significant phenotypi c characteristics of Candida dubliniensis (difference in the carbohydrate a ssimilation profile, difference in colony color on CHROMagar Candida, and p ositive tetrazolium test, etc.) have been found, but none of them seem to b e sufficient alone for the definitive identification of the species. Recent ly, PCR tests were developed to discriminate Candida albicans from Candida dubliniensis. However, these prove difficult in the context of routine myco logical diagnostics. Moreover, an increased resistance to antifungal drugs has been described. This shows the importance of identification of Candida dubliniensis. To elucidate the current insight into Candida dubliniensis, t he phenotypic and genotypic characteristics as well as the prevalence and t he antifungal drug susceptibilities of this species are discussed from a cl inical standpoint.